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The Barium Swallow in Thyroid Enlargement

Departments of Radiology and Endocrinology, New End Hospital, Hampstead, London, N.W.3

This excerpt was created in the absence of an abstract.

The barium swallow examination was urtdertaken as a routine pre-operative investigation in patients undergoing thyroidectomy, and the findings in 150 of these cases have been reviewed. It is noted that there may be marked oesophageal compression by the thyroid with no increase in the incidence of dysphagia. Most cases with severe compression of the upper oesophagus by the thyroid had had thyrotoxicosis and had been treated medically. This compression is not related to the size of the goitre or to pre-tracheal or posttracheal soft tissue enlargement. Marked oesophageal compression can also be caused by lymphadenoid goitre.

Marked oesophageal displacement is associated with nodular goitres. It is the only reliable method of assessing posterior intrathoracic extension of a cervical goitre.

Zenker's diverticulum and crico-pharyngeal webs are not infrequently found on routine examination and are usually symptomless. The size of the Zenker's diverticulum, in the early stages, appears to be related to the patient's age.